“ Endometrial tissue outside the uterus responds to hormonal signals from the menstrual cycle. This results in bleeding, inflammation and fi...
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Endometrial tissue outside the uterus responds to hormonal signals from the menstrual cycle. This results in bleeding, inflammation and fibrosis. Deposits of less than 3 mm are impossible to detect with imaging. Larger deposits (endometrioma/chocolate cyst) are diagnostic. Typically located in the pelvis (e.g. ‘cul de sac’), abdomen and also extra-abdominal sites, including the lungs (catamenial pneumothorax) and even the central nervous system.
CT
• Complex, heterogeneous cyst with or without extension to adjacent pelvic viscera
MRI
• Large mass, containing blood products of differing ages
• Tend to be multiple and bilateral
• Typically low signal on T2 with high-signal foci on T1 and T2 (blood products of different ages)
• May cause haematosalpinx (tubal endometriosis) or hydrosalpinx from obstruction
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